Identification, Coding, and Reimbursement of Pediatric Malnutrition at an Urban Academic Medical Center

Bierman, Sabrina M.; Peterson, Sarah J.; Chen, Yimin

doi:10.1002/ncp.10064

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…Malnutrition was found to be prevalent in 30% of pediatric inpatients in a single-center study in the United States; however, only 33% of malnourished patients were given a malnutrition-related ICD-10 code at discharge. A reimbursement calculation showed that coding for malnutrition resulted in an additional cost of US$27,664.70 to the hospital in 2 years [ 9 ]. Therefore, the true prevalence of nutritional disorders from ICD-10-CM codes was possibly underrepresented.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019

Saengnipanthkul¹,

Phosuwattanakul²,

Thepsuthammarat³

et al. 2022

Epidemiol Health

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OBJECTIVES:Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database. METHODS:Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63). RESULTS:Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM. CONCLUSIONS:Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019

Saengnipanthkul¹,

Phosuwattanakul²,

Thepsuthammarat³

et al. 2022

Epidemiol Health

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“…Thus malnutrition remains underrecognized, underdiagnosed, and underdocumented [7,11]. This compromises not only the patient's treatment and, consequently, clinical outcomes but also the scores of ROM and SOI, increasing the unclaimed potential reimbursement as a result of the lack of malnutrition diagnosis in the medical records [7,11,12,42].…”

Section: Discussionmentioning

confidence: 99%

Does malnutrition influence hospital reimbursement? A call for malnutrition diagnosis and coding

Fernandes

Pessoa²,

Vigário³

et al. 2020

Nutrition

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“…The International Classification of Disease, 10th Edition (ICD-10) codes 44.1 (mild protein malnutrition), E44.0 (moderate protein/calorie malnutrition), and E43.0 (severe protein/calorie malnutrition) should be used when appropriate. 4 The steps outlined above will enable the malnutrition diagnosis to be added to the All Patient Refined-Diagnosis Related Group (APR-DRG) payment methodology for that patient and that admission, thereby potentially increasing the actual hospital reimbursement. Furthermore, malnutrition impacts the severity of illness and risk of mortality scores, which can influence the hospital's performance on required quality-reporting dashboards and have downstream influences on reimbursement.…”

Section: How Does Billing and Reimbursement Work In The Neonatal Intensive Care Unit? Does The Rdn's Diagnosis Of Malnutrition Impact Thementioning

confidence: 99%

Applying the recommended indicators for the diagnosis of preterm and neonatal malnutrition: Answers to frequently asked questions

Goldberg

Becker

2021

Nut in Clin Prac

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In 2018, a committee of expert preterm/neonatal registered dietitian nutritionists published recommended indicators for the diagnosis of malnutrition in preterm infants and neonates. This was in response to a need for indicators appropriate to the preterm/neonatal population, given the emphasis on diagnosing malnutrition in the pediatric and adult population. Since the publication, the authors have received numerous questions regarding the application and use of the indicators. This paper answers questions regarding the three categories of indicators and billing and reimbursement. The goal is to develop uniformity in the application of the malnutrition indicators for quality improvement and research efforts.

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Identification, Coding, and Reimbursement of Pediatric Malnutrition at an Urban Academic Medical Center

Abstract: Malnutrition coding may have a significant financial impact and processes improvement efforts can be made to improve malnutrition coding.

Cited by 6 publications

References 6 publications

Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019

Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019

Does malnutrition influence hospital reimbursement? A call for malnutrition diagnosis and coding

Applying the recommended indicators for the diagnosis of preterm and neonatal malnutrition: Answers to frequently asked questions

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